Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-23T16:02:29.815Z Has data issue: false hasContentIssue false
  • English
  • Français

Effects of lipase inhibition on gastric emptying and alcohol absorption in healthy subjects

Published online by Cambridge University Press:  08 March 2007

Reawika Chaikomin ,
Antonietta Russo ,
Christopher K. Rayner ,
Christine Feinle-Bisset ,
Deirdre G. O'Donovan ,
Michael Horowitz  and
Karen L. Jones
Reawika Chaikomin
Affiliation:
Discipline of Medicine, University of Adelaide, Royal Adelaide Hospital, North Terrace Adelaide, South Australia, Australia, 5000
Antonietta Russo
Affiliation:
Discipline of Medicine, University of Adelaide, Royal Adelaide Hospital, North Terrace Adelaide, South Australia, Australia, 5000
Christopher K. Rayner
Affiliation:
Discipline of Medicine, University of Adelaide, Royal Adelaide Hospital, North Terrace Adelaide, South Australia, Australia, 5000
Christine Feinle-Bisset
Affiliation:
Discipline of Medicine, University of Adelaide, Royal Adelaide Hospital, North Terrace Adelaide, South Australia, Australia, 5000
Deirdre G. O'Donovan
Affiliation:
Discipline of Medicine, University of Adelaide, Royal Adelaide Hospital, North Terrace Adelaide, South Australia, Australia, 5000
Michael Horowitz
Affiliation:
Discipline of Medicine, University of Adelaide, Royal Adelaide Hospital, North Terrace Adelaide, South Australia, Australia, 5000
Karen L. Jones*
Affiliation:
Discipline of Medicine, University of Adelaide, Royal Adelaide Hospital, North Terrace Adelaide, South Australia, Australia, 5000
*
*Corresponding author: Dr Karen L. Jones, fax +61 8 8223 3870, email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The rate of alcohol absorption is dependent on gastric emptying (GE). As the slowing of GE by fat is dependent on lipolysis, orlistat may increase the rise in blood alcohol when alcohol is consumed with, or after, fat. The aim of the study was to evaluate the effects of orlistat on GE and blood alcohol after an alcohol-containing drink following a fat ‘preload’, in healthy subjects. Ten healthy males consumed 120 ml cream with or without 120 mg orlistat, 30 min before an alcohol-containing drink labelled with 20 MBq [99 mTc]sulfur colloid on 2 d. GE, plasma alcohol and blood glucose were measured. GE was slightly faster with orlistat (P<0·05) compared with control. Plasma alcohol at 15 min was slightly higher with orlistat (0·034 (sem 0·006) g/100 ml) v. control (0·029 (sem 0·005) g/100 ml) (P<0·05), but there was no effect on the area under the curve 0–240 min. The increase in blood glucose was greater with orlistat, for example, at 15 min (1·07 (sem 0·2) mmol/l) v. control (0·75 (sem 0·2) mmol/l) (P=0·05). The rise in blood glucose and plasma alcohol were related (for example, at 15 min r 0·49; P=0·03). In conclusion, lipase inhibition accelerates GE of an alcohol-containing drink following a fat ‘preload’ with a minor increase in the initial rise in plasma alcohol.

Keywords

Gastric emptyingOrlistatPlasma alcoholBlood glucose
Type
Research Article
Information
British Journal of Nutrition , Volume 96 , Issue 5 , November 2006 , pp. 883 - 887
Copyright
Copyright © The Nutrition Society 2006

References

Bastyr, EJ III, Stuart, CA, Brodows, RG, Schwartz, S, Graf, CJ, Zagar, A & Robertson, KE (2000) Therapy focused on lowering postprandial glucose, not fasting glucose, may be superior for lowering HbA1c. IOEZ Study Group. Diabetes Care 23, 1236–1241.Google Scholar
Borgstrom, B (1988) Mode of action of tetrahydrolipstatin: a derivative of the naturally occurring lipase inhibitor lipstatin. Biochim Biophys Acta 962, 308–;316.CrossRefGoogle ScholarPubMed
Borovicka, J, Schwizer, W, Guttmann, G, Hartmann, D, Kosinski, M, Wastiel, C, Bischof-Delaloye, A & Fried, M (2000) Role of lipase in the regulation of postprandial gastric acid secretion and emptying of fat in humans: a study with orlistat, a highly specific lipase inhibitor. Gut 46, 774–781.CrossRefGoogle ScholarPubMed
Caballeria, J, Frezza, M, Hernandez-Munoz, R, DiPadova, C, Korsten, MA, Baraona, E & Lieber, CS (1989) Gastric origin of the first-pass metabolism of ethanol in humans: effect of gastrectomy. Gastroenterology 97, 1205–1209.CrossRefGoogle ScholarPubMed
Carney, BI, Jones, KL, Horowitz, M, Sun, WM, Penagini, R & Meyer, JH (1995) Gastric emptying of oil and aqueous meal components in pancreatic insufficiency: effects of posture and on appetite. Am J Physiol 268, G925–G932.Google ScholarPubMed
Chaikomin, R, Doran, S, Jones, KL, Feinle-Bisset, C, O'Donovan, D, Rayner, CK & Horowitz, M (2005) Initially more rapid small intestinal glucose delivery increases plasma insulin, GIP, and GLP-1 but does not improve overall glycemia in healthy subjects. Am J Physiol 289, E504–E507.Google Scholar
Collins, PJ, Horowitz, M, Cook, DJ, Harding, PE & Shearman, DJ (1983) Gastric emptying in normal subjects – a reproducible technique using a single scintillation camera and computer system. Gut 24, 1117–1125.CrossRefGoogle ScholarPubMed
Cooper, JD (1971) Determination of blood ethanol by gas chromatography. Clin Chim Acta 33, 483–485.CrossRefGoogle ScholarPubMed
Cunningham, KM & Read, NW (1989) The effect of incorporating fat into different components of a meal on gastric emptying and postprandial blood glucose and insulin responses. Br J Nutr 61, 285–290.CrossRefGoogle ScholarPubMed
Davidson, MH, Hauptman, J & DiGirolamo, M (1999) Weight control and risk factor reduction in obese subjects treated for 2 years with orlistat: a randomized controlled trial. JAMA 281, 235–242.CrossRefGoogle ScholarPubMed
Del Prato, S (2002) In search of normoglycaemia in diabetes: controlling postprandial glucose. Int J Obes Relat Metab Disord 26, Suppl. 3, S9–S17.CrossRefGoogle ScholarPubMed
DiPadova, C, Worner, TM, Julkunen, RJ & Lieber, CS (1987) Effects of fasting and chronic alcohol consumption on the first-pass metabolism of ethanol. Gastroenterology 92, 1169–1173.CrossRefGoogle ScholarPubMed
Drent, ML & van der Veen, EA (1993) Lipase inhibition: a novel concept in the treatment of obesity. Int J Obes Relat Metab Disord 17, 241–244.Google Scholar
Edelbroek, MA, Horowitz, M, Wishart, JM & Akkermans, LM (1993) Effects of erythromycin on gastric emptying, alcohol absorption and small intestinal transit in normal subjects. J Nucl Med 34, 582–588.Google ScholarPubMed
Feinle, C, O'Donovan, D, Doran, S, Andrews, JM, Wishart, J, Chapman, I & Horowitz, M (2003) Effects of fat digestion on appetite, APD motility, and gut hormones in response to duodenal fat infusion in humans. Am J Physiol 284 G798–G807Google ScholarPubMed
Frezza, Mdi Padova, CPozzato, GTerpin, MBaraona, ELieber, CS (1990) High blood alcohol levels in women. The role of decreased gastric alcohol dehydrogenase activity and first-pass metabolism. N Engl J Med 322 95–99.Google Scholar
Hebbard, GSSun, WMBochner, FHorowitz, M (1995) Pharmacokinetic considerations in gastrointestinal motor disorders. Clin Pharmacokinet 28, 41–66.CrossRefGoogle ScholarPubMed
Holt, S (1981) Observations on the relation between alcohol absorption and the rate of gastric emptying. Can Med Assoc J 124, 267–277.Google ScholarPubMed
Horowitz, M, Cunningham, KM, Wishart, JM, Jones, KL & Read, NW (1996) The effect of short-term dietary supplementation with glucose on gastric emptying of glucose and fructose and oral glucose tolerance in normal subjects. Diabetologia 39, 481–486.CrossRefGoogle ScholarPubMed
Horowitz, M, Edelbroek, MA, Wishart, JM & Straathof, JW (1993 a) Relationship between oral glucose tolerance and gastric emptying in normal healthy subjects. Diabetologia 36, 857–862.CrossRefGoogle ScholarPubMed
Horowitz, M, Jones, K, Edelbroek, MA, Smout, AJ & Read, NW (1993 b) The effect of posture on gastric emptying and intragastric distribution of oil and aqueous meal components and appetite. Gastroenterology 105, 382–390.Google Scholar
Horowitz, M, Maddox, A, Bochner, M, Wishart, J, Bratasiuk, R, Collins, P & Shearman, D (1989) Relationships between gastric emptying of solid and caloric liquid meals and alcohol absorption. Am J Physiol 257, G291–G298.Google ScholarPubMed
Hunt, JN, Smith, JL & Jiang, CL (1985) Effect of meal volume and energy density on the gastric emptying of carbohydrates. Gastroenterology 89, 1326–1330.CrossRefGoogle ScholarPubMed
Johnson, RD, Horowitz, M, Maddox, AF, Wishart, JM & Shearman, DJ (1991) Cigarette smoking and rate of gastric emptying: effect on alcohol absorption. BMJ 302, 20–23.Google Scholar
Jones, KL, Horowitz, M, Carney, BI, Wishart, JM, Guha, S & Green, L (1996) Gastric emptying in early noninsulin-dependent diabetes mellitus. J Nucl Med 37, 1643–1648.Google Scholar
Lin, HC, Doty, JE, Reedy, TJ & Meyer, JH (1989) Inhibition of gastric emptying by glucose depends on length of intestine exposed to nutrient. Am J Physiol 256, 404–G411.Google ScholarPubMed
Lin, HC, Zhao, XT & Wang, L (1996) Fat absorption is not complete by midgut but is dependent on load of fat. Am J Physiol 271, G62–G67.Google Scholar
Melia, AT, Zhi, J, Zelasko, R, Hartmann, D, Guzelhan, C, Guerciolini, R & Odink, J (1998) The interaction of the lipase inhibitor orlistat with ethanol in healthy volunteers. Eur J Clin Pharmacol 54, 773–777.Google Scholar
Nimmo, WS (1976) Drugs, diseases and altered gastric emptying. Clin Pharmacokinet 1, 189–203.CrossRefGoogle ScholarPubMed
O'Donovan, D, Horowitz, M, Russo, A, Feinle-Bisset, C, Murolo, N, Gentilcore, D, Wishart, JM, Morris, HA & Jones, KL (2004 a) Effects of lipase inhibition on gastric emptying of, and on the glycaemic, insulin and cardiovascular responses to, a high-fat/carbohydrate meal in type 2 diabetes. Diabetologia 47, 2208–2214.CrossRefGoogle ScholarPubMed
O'Donovan, DG, Doran, S, Feinle-Bisset, C, Jones, KL, Meyer, JH, Wishart, JM, Morris, HA & Horowitz, M (2004 b) Effect of variations in small intestinal glucose delivery on plasma glucose, insulin, and incretin hormones in healthy subjects and type 2 diabetes. J Clin Endocrinol Metab 89, 3431–3435.CrossRefGoogle ScholarPubMed
Pilichiewicz, A, O'Donovan, D, Feinle, C, Lei, Y, Wishart, JM, Bryant, L, Meyer, JH, Horowitz, M & Jones, KL (2003) Effect of lipase inhibition on gastric emptying of, and the glycemic and incretin responses to, an oil/aqueous drink in type 2 diabetes mellitus. J Clin Endocrinol Metab 88, 3829–3834.CrossRefGoogle Scholar
Rayner, CK, Samsom, M, Jones, KL & Horowitz, M (2001) Relationships of upper gastrointestinal motor and sensory function with glycemic control. Diabetes Care 24, 371–381.CrossRefGoogle ScholarPubMed
Saydah, SH, Miret, M, Sung, J, Varas, C, Gause, D & Brancati, FL (2001) Postchallenge hyperglycemia and mortality in a national sample of U.S.adults. Diabetes Care 24, 1397–1402.CrossRefGoogle Scholar
Schwizer, W, Asal, K, Kreiss, C, Mettraux, C, Borovicka, J, Remy, B, Guzelhan, C, Hartmann, D & Fried, M (1997) Role of lipase in the regulation of upper gastrointestinal function in humans. Am J Physiol 273, G612–G620.Google Scholar
Stacher, G, Bergmann, H, Gaupmann, G, Schneider, C, Kugi, A, Hobart, J, Binder, A & Mittelbach-Steiner, G (1990) Fat preload delays gastric emptying: reversal by cisapride. Br J Clin Pharmacol 30, 839–845.CrossRefGoogle ScholarPubMed
Stacher, G, Granser, GV, Bergmann, H, Kugi, A, Stacher-Janotta, G & Hobart, J (1991) Slow gastric emptying induced by high fat content of meal accelerated by cisapride administered rectally. Dig Dis Sci 36, 1259–1265.CrossRefGoogle ScholarPubMed
Welch, IM, Bruce, C, Hill, SE & Read, NW (1987) Duodenal and ileal lipid suppresses postprandial blood glucose and insulin responses in man: possible implications for the dietary management of diabetes mellitus. Clin Sci (Lond) 72, 209–216.CrossRefGoogle ScholarPubMed